US Measles Outbreak Part 2

Transcript

Sue: 0:07

Have you been wondering why the measles outbreak in the US is a big deal?

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Hi. Welcome to Healthcare. Right now, the podcast that's asking what the health is going on. My name is Sue, and I'm your host.

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I'm an RN with 20 plus years of experience in the nursing field, and I want to help you understand America's health landscape and more importantly, the things that you can do to help maximize your care.

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And the disclaimer, of course, is that this podcast is for educational and entertainment purposes only. Please contact your doctor for any health concerns that you have. Measles. Why do we even care about what used to be a normal childhood illness that everyone would get? Well, it's because measles can have some really nasty complications. Last episode, we addressed what measles is, signs and symptoms of the disease, and why health officials are concerned. Today we are going to address what the US used to look like. Pre MMR vaccine. That stands for measles, mumps, and Rubella. It's a combo vaccine. We'll talk about severe complications of the disease. And what we are doing about the outbreak going on in the US right now.

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Let's go over some historical context of measles. In the ninth century, a Persian doctor published one of the first written accounts of the measles disease. So this disease has been with us as humans for a very long time.

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In 1757, a Scottish doctor named Francis home showed that measles is caused by an infectious agent. It took humans a very long time to get savvy to germ theory.

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In 1912, measles became a nationally notifiable disease in the United States requiring US healthcare providers and laboratories to report all diagnosed cases. Most communicable diseases are tracked in this way by most countries. It's a form of infection control. Both communicable or contagious and non-communicable or non-contagious diseases are tracked. So let's take a look at the statistics and impact of measles. In the first decade of reporting, from 1912 to 1922 ish, an average of 6,000 measles related deaths were reported. Each year, nearly all children got measles. By the time they were 15 years old, an estimated three to 4 million people in the United States were infected Each year. By 1963, the year the vaccine came out and estimated four to 500 people died of measles each year, and 48,000 were hospitalized. About 1000 of those cases suffered encephalitis or swelling of the brain. No longer were 6,000 people dying, but about four to 500 were, and when you consider that population is mostly children who are infected, that's a significant and tragic number, all the same. And almost 50,000 hospitalizations from one illness is quite a bit in the pediatric population. By 2021 through the use of vaccines, we brought the death rate from measles down to zero in the us. Zero deaths. That's amazing. That's the power of herd immunity. Vaccination is a powerful tool in the arsenal against disease.

Sue: 3:35

So let's look at vaccine development in 1954, John f Enders and Dr. Thomas c Peebles collected blood samples from several ill students during a measles outbreak in Boston, Massachusetts. In 1963, Enders and his colleagues transformed their strain of measles virus into a vaccine and licensed it in the United States T hen in 1968, an improved an even weaker measles vaccine was developed by Maurice Heman and colleagues, and that began to be distributed. This vaccine is called the Sten Enders strain, and it's still the one that's used today. The impact of vaccination is clear. By 1981, the number of reported measles cases was 80% less. Measles was declared eliminated from the United States in 2000. Now elimination is different than eradication.

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Elimination is a term used by epidemiologists to mean that there are no cases in a given area. Eradication means the disease is gone everywhere on the entire planet and to date, the only disease we have eradicated is smallpox. And that was through the use of vaccines. During this current outbreak as of April 17, 2025, a total of 800 confirmed measles cases were reported by 25 jurisdictions. So that's 24 states, and also New York City. I'm not sure if it's due to its size, but New York City is its own CDC jurisdiction 94% of confirmed cases, or 751 of the 800 are outbreak associated. There have been a couple of others that. Brought measles back with them when they were traveling.

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Now we're gonna talk about health risks and complications. Measles is a highly contagious respiratory illness. Early symptoms to review include high fever, cough, runny nose, red, watery eyes, followed by that characteristic body rash that starts at the head and moves down. Rare complications can be severe, and those include pneumonia. Blindness and encephalitis. The CDC website does break down the complications of this current outbreak. If you're interested in that. It looks like about 11% of the cases have been hospitalized, so 85 out of those 800 infected at the last update there have sadly been two deaths and one death that's still under investigation. Again, that may not seem like a lot, but two deaths out of 800, that's a one in 400 chance, and I think that that is way too many. Even if you think that's not a lot, I want you to consider that having a child that is critically ill. Is intensely stressful. Ask someone you know that has had a child in the ICU or the nicu. It's awful. It's stressful and it's heartbreaking. This is something that you should avoid if you can, and fortunately you can through vaccination. Let's talk about some of the complications that are associated with measles. First we have that immune amnesia. This is present at some level in every single case of the measles. Kids lose their immune memory because of how the virus hijacks our immune system to spread. It can take two to five years to get your immune system back on track. We talked about this on the last episode, so I'm going to move on. Pneumonia is the most common severe complication from measles. It occurs in one out of every 20 cases that's very high. Remember in the last episode that we talked about how measles is an airborne virus? It replicates in the respiratory tract of humans. This is where it hits first and it can hit hard. Recall that the early symptoms are cough and runny nose. So now one in 20 get pneumonia, but one in 20 don't die. So we're obviously providing very good supportive care for these kids here in the us. That includes airway and respiratory support, oxygen nutrition, and treating any complications that arise. It's a viral pneumonia, so antibiotics will not work for the measles itself, but they may be used to treat what we call secondary pneumonia. Secondary pneumonia is when a virus comes along and infects the host, and the host's response to the viral infection is to create mucus and try to eradicate the virus through trapping it with mucus and coughing it up. But that mucus sets up this beautiful, warm, moist. Sorry about using the M word environment for bacteria to set up camp in the lungs. That combined with a host that's already weakened from fighting the primary infection of measles, the child can get a secondary pneumonia by the conditions that were set up by the virus. This is very common with many different respiratory viruses In the hospital setting, if a patient is ill enough to be there, doctors usually just start the patient on antibiotics empirically, or meaning they assume that there is some level of secondary pneumonia going on in addition to that primary viral pneumonia. The good news is most patients recover. But let's talk about that funny word I mentioned last week, sequela. This is lasting effects of an illness. The effects can last for weeks, months, years. They could be lifelong. Now this is different than complications of pneumonia, which can be things like pleural, effusions, tension pneumothorax, low oxygen levels, things like that.

Sue: 9:31

We're talking about measles having pneumonia as a complication. So I'm going to move on to the long-term issues post measles pneumonia, the most common one. Is lung issues. No surprise there. Kids' lungs may develop scar tissue, which reduces lung compliance or the ability to stretch and recoil like the lungs need to do when you're breathing. This will set them up for future infections. They may have more severe respiratory infections in the future than their classmates or siblings. They can develop reactive lung disease, so an asthma like condition and ammonia can take a. Long, long time to recover from. Even for kids They may have to deal with cough, weakness, and fatigue for several months, even after they've recovered from the measles virus itself.

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Now we're gonna talk about encephalitis, which is swelling of the brain. This is one of the big scary complications for measles. This is one of the ones that would freak me out and keep me up at night if my kids had measles. Honestly, why? Well, I'm gonna give you an analogy that my professors taught me in nursing school. I want you to think of your brain, kind of like the consistency of finger jello, so that firmer jello that you can pick up on your fingers and kind of squish a little bit, and your skull is a very hard box that you keep that finger jello in. So I want you to picture a very large piece of finger jello inside of a clear, hard plastic container.

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This piece of jello fits very snugly into that Tupperware box. There's no space between the jello and that box. It fits exactly. The box is very hard. It does not move, it does not expand and it does not contract. So that's the example of your skull because it's made of bone. Your skull does not have any give unless there's damage and that's bad in a different way. But back to encephalitis. Now you have encephalitis or swelling of the brain because of the virus. If you think about that as the jello in the box, the jello is expanding inside that box, but there is no room for that jello to expand. So what happens to that jello if there's no room for it to expand? The jello is going to start getting squished against the box, isn't it? So when you squish your jello brain against the box, you damage it. This damage can look like hearing loss, blindness or intellectual disabilities. That would be the sequela of encephalitis, long-term brain damage that the patient would not recover from. Encephalitis occurs at a rate of one kid and every 1000 cases that's decently high for a complication. That is so devastating. Not my kid. No way. Not if I can help it. And again, I can through vaccination. The last complication that we are going to talk about is called SSPE or subacute sclerosing pan encephalitis. I'm only gonna say that word once. We're gonna call it SSPE from now on. This is another encephalitis like complication that has to do with inflammation in the brain. SSPE generally develops seven to 10 years after the person has measles, even though the person seems to have fully recovered from the illness. SSPE is very. Very rare, but completely devastating When it occurs. What happens, they believe is that the measles virus becomes reactivated. Because SSPE is so rare, I cannot find a lot of data on it, but it must be something similar to how the varicella or the chickenpox virus can stick around in the body and then get reactivated during low immune times. For chickenpox, that looks like shingles. Shingles is devastating enough, but SSPE is just horrific. The signs and symptoms include memory loss. Irritability, seizures, involuntary muscle movements and or behavioral changes that lead to neurologic deterioration. If that sounds a lot like dementia to you, then yes, it does to me too. But in a teenager, there is nothing medical science can do at this time. Symptoms continue until the patient dies, and that usually occurs in about two years after symptoms begin. Data from the small resurgence of measles in the United States from 1989 to 1991 concluded that seven to 11 out of every 100,000 were estimated to be at risk for developing SSPE. So very, very rare. This is actually followed by Nord or our National Organization of Rare Disorders. But again, if it does occur, it is very devastating for families facing this. My heart goes out to anyone who has to watch their child mentally and physically deteriorate before their eyes. NPR recently had a doctor on one of their talk shows talking about a case of SSPE that happened in the United States, and it was terribly, terribly devastating. You can look that up on the NPR website, and I should have a link in the show notes as well. The risk of developing SSPE may be higher for a person who gets measles before they're two years old. What organizations are responding to the outbreak in the United States and what are they doing? The primary response comes from the HHS or the Health and Human Services branch of the government. This is an umbrella organization. You can think of Secretary Robert F. Kennedy as the one holding the umbrella. And then most of our health organizations fall under that umbrella, such as the National Institute of Health, the CDC, the FDA, and many others. Secretary Kennedy has been criticized as being slow to respond to this outbreak. Critics say. This is due to Kennedy's personal belief that the MMR vaccine causes autism. Let me be clear, it does not many studies have proven this repeatedly, and we can talk about that more in the next episode. However, to Secretary Kennedy's credit, after receiving a large amount of pressure following the deaths of two children, Kennedy did put out a statement saying that the MMR vaccine is both safe and effective and that people should get vaccinated. That is the best way to beat this virus if there is not a vulnerable population to infect. The virus will die down again. What are some of the actions Kennedy, as HHS secretary has enacted? He has directed the Centers for Disease Control and Prevention and the Administration for strategic Preparedness and response to work closely with the Texas Health Authorities. Efforts include offering technical assistance, laboratory support, vaccines, and therapeutic medications as needed. He also ordered continuous communication with the Texas Health officials to ensure a coordinated and effective response. Kennedy states that he is committed to providing additional support to bring the outbreak to an end. These are all wonderful things, but I do have one more critique. Secretary Kennedy has been championing vitamin A as a cure while Vitamin A is a treatment that is used in the hospital setting. Let me be clear. You cannot just take vitamin A and have all of your symptoms go away. It is not a cure. It is not that simple. I wish it was. That would be wonderful. It would be wonderful if vitamins were a cure for a disease. I did see something similar in COD. Much of the population would say to us, just give my loved one vitamin C in sync. Well, we did daily, but you cannot out vitamin A serious virus listeners. Also please note vitamin A is toxic in large doses because it is a fat soluble vitamin part of the Adec group, we call it, or A DEK Adec. These can accumulate in the liver and cause organ damage. Hospitals in Texas have seen some vitamin A overdoses since Kennedy's statements. You cannot use vitamin A to prevent measles. Good nutrition is incredibly important. I will never say that nutrition is not important, but measles is a highly infectious disease and vitamin A cannot keep you from being infected. Can it help your body fight? Sure. Good nutrition is so important for your immune system to have the tools that it needs. Please continue to take your vitamins if you feel that they are beneficial to you and you're not taking more than the recommended amount and strive diligently to get good nutrition to you and your children. Good. Nutrition is always a great place to start for health. But please note that the studies that showed vitamin A as being very beneficial were done in populations that have vitamin A deficiency. giving vitamins to children who are lacking those vitamins is going to yield bigger results than giving vitamins to children who already have sufficient amounts in their system. Most American children are not clinically malnourished. Thank goodness. Unfortunately, that means vitamin A will have some benefit, but not as much as we see in malnourished populations. When I criticize Kennedy, please do not feel that this is partisan. I do not feel that Kennedy is a Republican. He has never been a Republican. He is a tiger who changed his stripes in order to gain the position of power that he wanted he played the political game. Very well. That's how he's in the Trump administration now. When I criticize him on these things, it is purely from the point of a medical background, which is something that Kennedy does not have. You will note that every medical doctor, in America's opinion on this, is the same. Vaccination is safe and effective, and it is the best protection from measles. I will praise Kennedy in a future episode for some things that I feel that he's doing right and that make medical sense even if his reasoning on those things is different than medical consensus. I believe in taking the good where you can get it in conclusion. Measles is a disease you can avoid. And if you can, you should. Since this disease comes with some serious complications, we must continue to stress vaccination in our population along with normal infectious controls techniques such as hand washing, staying home when you're ill, covering your coughs, et cetera. My call to action this week is the same as it was last week with a few additions. Stay informed and support vaccination efforts. Get your tighter drawn if you have concerns about your own immunity. Vaccinate your eligible children, and here's where my call to action gets deeper, spread, truthful evidence-based information to others. We live in a time. Where those who know the truth need to speak out to counter the rhetoric of those who do not follow best practices and evidence-based health practices. It is a battle of ideas out there right now. Let's let our logical reasoned arguments find their way into the public space more than those that do not make sense. Use reliable sources of information. Also be kind to others. I firmly believe that we are not going to get anywhere in America right now with the gotcha attitude. I have been guilty of the gotcha attitude myself, so to those that I have treated badly. In the past in any way. This is my sincere apology. We need to show our fellow Americans love and understanding because what is the end goal here? What is the North Star? The North Star is a strong and healthy America. That is what we all really want. I wanna remind you of a saying. Play stupid games, win stupid prizes. As a nation, we've been playing the only, the opposite side game for about a decade and a half now. Stupid prize we all won? Deep division, the kind that tears families, communities, and nations apart. We all have more in common than the other side thinks it is time to focus on our commonalities on truth and on logic. Radically refuse to be outraged this week. Radically refuse to be sucked into an argument from the news and social media outlets that are trying to outrage you for ratings and for likes. Radically resolve to have empathy for your fellow American, even if that fellow American is on the opposite team than you are Radically resolve to actively build connection with others. That's the pathway through. I love you all so very much and I'm so happy to be part of this nation despite our pain and struggles, and I'm so proud of the American spirit and American ingenuity that can carry us through this time. This outbreak will be no different. Thank you so much for listening, like and subscribe. If you're watching on YouTube, if you're on the podcast channel, please add me to your favorites. Take care. Thank you so much for listening Like and subscribe if you are watching on YouTube. If you are on the Podcast channels, add me to your favorites. Measles vaccine creation https://www.cdc.gov/measles/about/history.html#:~:text=In%201954,%20John%20F.%20Enders%20and%20Dr.%20Thomas%20C.

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History of Water in the US: https://archive.epa.gov/water/archive/web/pdf/2001_11_15_consumer_hist.pdf American Flu stats https://www.cdc.gov/flu/highrisk/children.html#:~:text=Each%20year%2C%20millions%20of%20children%20get%20sick%20with,rare%20cases%2C%20flu%20complications%20can%20lead%20to%20death.

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HHS data https://www.hhs.gov/press-room/measles-outbreak-call-to-action-for-all-of-us.html CDC Data https://www.cdc.gov/measles/data-research/index.html https://www.cdc.gov/measles/signs-symptoms/index.html PNA sequelae in kids https://pmc.ncbi.nlm.nih.gov/articles/PMC3285155/ SSPE https://rarediseases.org/rare-diseases/subacute-sclerosing-panencephalitis/ NPR SSPE https://www.npr.org/2025/03/14/nx-s1-5324745/the-dangers-of-measles-can-be-severe-and-long-lasting-doctors-warn https://www.idsociety.org/science-speaks-blog/2025/talking-to-patients-about-measles-vitamin-a-and-the-importance-of-vaccination/#/+/0/publishedDate_na_dt/desc/